1811165319 NPI number — TON SAN SIMON HEALTH CENTER

Table of content: AARON JOSEPH REINICKE LMFT (NPI 1740765759)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811165319 NPI number — TON SAN SIMON HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TON SAN SIMON HEALTH CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811165319
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DHHS PHS IHS TUCSON AREA
Provider Second Line Business Mailing Address:
PO BOX 31001-1021
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91110-1021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HIGHWAY 86, MILEPOST 84
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SELLS
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-362-7007
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HOFFMAN
Authorized Official First Name:
LYNNITA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
520-383-7200

Provider Taxonomy Codes

  • Taxonomy code: 332800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0355188 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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